Scholars@Duke
Andrew Walker McCrary

Andrew Walker McCrary

Associate Professor of Pediatrics
Pediatrics, Cardiology

Selected Publications

Correlating Severity of Pulmonary Hypertension by Echocardiogram with Mortality in Premature Infants with Bronchopulmonary Dysplasia.

Journal Article Am J Perinatol · December 2024 OBJECTIVE:  Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth. Infants with BPD are at increased risk for pulmonary hypertension (PH). Cardiac catheterization is the gold standard for diagnosing PH, but cardiac catheterizati ... Full text Link to item Cite

Making it work for all: equity in single ventricle monitoring.

Journal Article Cardiol Young · October 23, 2024 BACKGROUND: Interstage monitoring programs for single ventricle disease have been developed to reduce morbidity and mortality. There is increased use of telemedicine and mobile application monitoring. It is unknown if there are disparities in use based on ... Full text Link to item Cite

Detection of occult thrombosis in individuals with Fontan circulation by cardiac MRI.

Journal Article Cardiol Young · July 2024 OBJECTIVE: Identifying thrombus formation in Fontan circulation has been highly variable, with reports between 17 and 33%. Initially, thrombus detection was mainly done through echocardiograms. Delayed-enhancement cardiac MRI is emerging as a more effectiv ... Full text Link to item Cite

Proteomics discovery in children and young adults with HIV identifies fibrosis, inflammatory, and immune biomarkers associated with myocardial impairment.

Journal Article AIDS · June 1, 2024 People with HIV are at increased risk of cardiac dysfunction; however, limited tools are available to identify patients at highest risk for future cardiac disease. We performed proteomic profiling using plasma samples from children and young adults with pe ... Full text Link to item Cite

Textbook Outcome for Superior Cavopulmonary Connection: A Metric for Single Ventricle Heart Surgery.

Journal Article World J Pediatr Congenit Heart Surg · May 2024 Background: To develop a more holistic measure of congenital heart center performance beyond mortality, we created a composite "textbook outcome" (TO) for the Glenn operation. We hypothesized that meeting TO would have a positive prognostic and financial i ... Full text Link to item Cite

Staged repair of borderline hypoplastic heart disease with early biventricular conversion.

Conference JTCVS Tech · April 2024 OBJECTIVE: In select patients with borderline ventricular hypoplasia, we adopted a strategy of initial single-ventricle palliation followed by staged or direct biventricular conversion by 2 years of age. METHODS: Between 2018 and 2023, 14 newborns with bor ... Full text Link to item Cite

Obesity Predisposes Anthracycline-Treated Survivors of Childhood and Adolescent Cancers to Subclinical Cardiac Dysfunction.

Journal Article Pediatr Cardiol · March 8, 2024 Anthracyclines are effective chemotherapeutics used in approximately 60% of pediatric cancer cases but have a well-documented risk of cardiotoxicity. Existing cardiotoxicity risk calculators do not include cardiovascular risk factors present at the time of ... Full text Link to item Cite

Diffuse myocardial fibrosis is uncommon in people with perinatally acquired human immunodeficiency virus infection.

Journal Article AIDS Res Ther · March 4, 2024 BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people wi ... Full text Link to item Cite

Development and Temporal Validation of a Machine Learning Model to Predict Clinical Deterioration.

Journal Article Hosp Pediatr · January 1, 2024 OBJECTIVES: Early warning scores detecting clinical deterioration in pediatric inpatients have wide-ranging performance and use a limited number of clinical features. This study developed a machine learning model leveraging multiple static and dynamic clin ... Full text Link to item Cite

Center-level factors associated with shorter length of stay following stage 1 palliation: An analysis of the national pediatric cardiology quality improvement collaborative registry.

Journal Article Am Heart J · November 2023 BACKGROUND: Stage 1 single ventricle palliation (S1P) has the longest length of stay (LOS) of all benchmark congenital heart operations. Center-level factors contributing to prolonged hospitalization are poorly defined. METHODS: We analyzed data from infan ... Full text Link to item Cite

Risk of in-hospital Deterioration for Children with Single Ventricle Physiology.

Journal Article Pediatr Cardiol · August 2023 Children with single ventricle physiology (SV) are at high risk of in-hospital morbidity and mortality. Identifying children at risk for deterioration may allow for earlier escalation of care and subsequently decreased mortality.We conducted a retrospectiv ... Full text Link to item Cite

Ultrasound Visualization and Recording of Transient Myocardial Vibrations.

Journal Article Ultrasound Med Biol · June 2023 OBJECTIVE: A new visualization and recording method used to assess and quantitate autogenic high-velocity motions in myocardial walls to provide a new description of cardiac function is described. METHODS: The regional motion display (RMD) is based on high ... Full text Link to item Cite

Sustained Total All-Region Perfusion During the Norwood Operation and Postoperative Recovery.

Journal Article Semin Thorac Cardiovasc Surg · 2023 We developed a technique for the Norwood operation utilizing continuous perfusion of the head, heart, and lower body at mild hypothermia named Sustained Total All-Region (STAR) perfusion. We hypothesized that STAR perfusion would be associated with shorter ... Full text Link to item Cite

Survival After Intervention for Single-Ventricle Heart Disease Over 15 Years at a Single Institution.

Journal Article Ann Thorac Surg · December 2022 BACKGROUND: Children with single-ventricle (SV) heart disease possess a spectrum of heart malformations, yet progress through similar hemodynamic states, suggesting differences in outcomes are related to fundamental morphologic differences, patient charact ... Full text Link to item Cite

Impact of Udenafil on Echocardiographic Indices of Single Ventricle Size and Function in FUEL Study Participants.

Journal Article Circ Cardiovasc Imaging · November 2022 BACKGROUND: The FUEL trial (Fontan Udenafil Exercise Longitudinal) demonstrated statistical improvements in exercise capacity following 6 months of treatment with udenafil (87.5 mg po BID). The effect of udenafil on echocardiographic measures of single ven ... Full text Link to item Cite

Tricuspid regurgitation and left ventricular eccentricity as a measure of heart failure in the newborn patient with a vein of Galen malformation: illustrative case.

Journal Article J Neurosurg Case Lessons · October 10, 2022 BACKGROUND: Successful management of a vein of Galen malformation (VoGM) in the newborn patient requires a highly coordinated team approach involving neonatologists, pediatric cardiologists, pediatric neurologists, neurosurgeons, and interventionalists. In ... Full text Link to item Cite

Postoperative Renal Failure, Shunt Type, and Mortality After Norwood Palliation.

Journal Article Ann Thorac Surg · June 2022 BACKGROUND: The Single Ventricle Reconstruction Trial demonstrated increased risk of death or heart transplant 1 year after Norwood among subjects randomly assigned to modified Blalock-Taussig shunts compared with right ventricle to pulmonary artery (RV-PA ... Full text Link to item Cite

Early cardiac dysfunction in children and young adults with perinatally acquired HIV.

Journal Article AIDS · March 15, 2020 OBJECTIVE: To define the prevalence of early cardiac dysfunction in children and young adults with perinatally acquired HIV and predictors of cardiac function. DESIGN: Cross-sectional design. METHODS: Early cardiac dysfunction was defined as left ventricul ... Full text Link to item Cite

Workforce Cost Model for Expanding Congenital and Rheumatic Heart Disease Services in Kenya.

Journal Article World J Pediatr Congenit Heart Surg · May 2019 BACKGROUND: Cardiovascular disease is the number one global killer, with over three quarters of these deaths arising from the populations of low- and middle-income countries (LMICs). Addressing the burden of cardiovascular disease in LMICs must include med ... Full text Link to item Cite

Agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers.

Journal Article J Perinatol · February 2019 OBJECTIVE: To evaluate the agreement of an echocardiogram-based pulmonary hypertension diagnosis in premature infants at risk for bronchopulmonary dysplasia (BPD). STUDY DESIGN: Echocardiograms from infants born ≤28 weeks post menstrual age were retrospect ... Full text Link to item Cite

Features of cardiovascular disease in low-income and middle-income countries in adults and children living with HIV.

Journal Article Curr Opin HIV AIDS · November 2017 PURPOSE OF REVIEW: The current article addresses crucial issues in identifying risk of cardiovascular disease (CVD) in people living with HIV in low-income and middle-income countries (LMICs). These issues are in need of urgent attention to advance our kno ... Full text Link to item Cite

Radiofrequency Ablation in the Sinus of Valsalva for Ventricular Arrhythmia in Pediatric Patients.

Journal Article Pediatr Cardiol · December 2016 The need to perform catheter ablation of ventricular arrhythmia from within the sinuses of Valsalva in a pediatric patient is uncommon. This has been reported in adults, but there are little data about the feasibility, safety or efficacy of catheter ablati ... Full text Link to item Cite

Differences in Eccentricity Index and Systolic-Diastolic Ratio in Extremely Low-Birth-Weight Infants with Bronchopulmonary Dysplasia at Risk of Pulmonary Hypertension.

Journal Article Am J Perinatol · January 2016 OBJECTIVE: To compare the left ventricular eccentricity index (EI) and tricuspid valve systolic-diastolic (SD) ratio in infants at risk of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH). STUDY DESIGN: Review of echocardiograms performed o ... Full text Link to item Cite

Patient and practice factors affecting growth of infants with systemic-to-pulmonary shunt.

Journal Article Cardiol Young · August 2013 BACKGROUND: On recognising poor growth following neonatal palliation with a systemic-to-pulmonary shunt, we sought to determine how patient- and procedure-related factors impact growth, paying attention to the role of the primary cardiologist in this proce ... Full text Link to item Cite